BACKGROUND Increasing data suggest emergent affective symptoms during the COVID-19 pandemic. OBJECTIVES To study the impact of the COVID-19 pandemic on affective symptoms and suicidal ideation in Thai adults. METHODS The Collaborative Outcomes Study on Health and Functioning during Infection Times uses non-probability sampling (chain referring and voluntary response sampling) and stratified probability sampling to identify risk factors of mental health problems and potential treatment targets to improve mental health outcomes during pandemics. FINDINGS Analysing 14 271 adult survey participants across all four waves of the COVID-19 pandemic in Thailand, covering all 77 provinces from 1 June 2020 to 30 April 2022, affective symptoms and suicidality increased during COVID-19 pandemic. Affective symptoms were strongly predicted by pandemic (feelings of isolation, fear of COVID-19, loss of social support, financial loss, lack of protective devices) and non-pandemic (female sex, non-binary individuals, adverse childhood experiences (ACEs), negative life events, student status, multiple mental health and medical conditions, physical pain) risk factors. ACEs, prior mental health conditions and physical pain were the top three risk factors associated with both increased affective symptoms and suicidal ideation during the COVID-19 pandemic. Partial least squares analysis showed that ACEs were the most important risk factor as they impacted most pandemic and non-pandemic risk factors. CLINICAL IMPLICATIONS Rational policymaking during a pandemic should aim to identify the groups at highest risk (those with ACEs, psychiatric and medical disease, women, non-binary individuals) and implement both immediate and long-term strategies to mitigate the impact of ACEs, while effectively addressing associated psychiatric and medical conditions.

中文翻译：

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COVID-19 大流行期间情感症状和自杀意念增加的预测因素：对 14 271 名泰国成年人的大规模研究的结果。


背景 越来越多的数据表明，在 COVID-19 大流行期间会出现紧急情感症状。目的 研究 COVID-19 大流行对泰国成年人情感症状和自杀意念的影响。方法 感染期间健康和功能的协作结果研究使用非概率抽样（链式参考和自愿反应抽样）和分层概率抽样来确定心理健康问题的风险因素和潜在的治疗目标，以改善大流行期间的心理健康结果。调查结果 分析了 2020 年 6 月 1 日至 2022 年 4 月 30 日期间泰国所有四波 COVID-19 大流行的 14 271 名成人调查参与者，覆盖所有 77 个省份，在 COVID-19 大流行期间，情感症状和自杀倾向有所增加。大流行 （孤立感、对 COVID-19 的恐惧、失去社会支持、经济损失、缺乏防护装置） 和非大流行 （女性、非二元个体、不良童年经历 （ACEs）、消极生活事件、学生身份、多种心理健康和医疗状况、身体疼痛）风险因素强烈预测情感症状。ACEs、既往心理健康状况和身体疼痛是 COVID-19 大流行期间与情感症状增加和自杀意念相关的前三大风险因素。偏最小二乘法分析显示，ACE 是最重要的风险因素，因为它们影响了大多数大流行和非大流行风险因素。 临床意义 大流行期间的理性决策应旨在确定风险最高的群体（ACE 患者、精神和医学疾病患者、女性、非二元个体），并实施短期和长期战略以减轻 ACE 的影响，同时有效解决相关的精神和医疗状况。